Adults receiving chemotherapy treatment along with oral cryotherapy showed a reduction in oral mucositis of any severity when compared to the control of standard care or no treatment (RR 0.61, 95% CI 0.52 to 0.72). When considering only the patients with moderate to severe oral mucositis, similar reduction of the condition occurred (RR 0.52, 95% CI 0.41 to 0.65). The patients with severe oral mucositis also showed reduction (RR 0.40, 95% CI 0.27 to 0.61). Patients with any level of severity of oral mucositis showed reduction of the symptoms with oral cryotherapy treatment.

Evidence Search

("mouth"[MeSH Terms] OR "mouth"[All Fields] OR "oral"[All Fields]) AND ("cryotherapy"[MeSH Terms] OR "cryotherapy"[All Fields]) AND ("stomatitis"[MeSH Terms] OR "stomatitis"[All Fields] OR ("oral"[All Fields] AND "mucositis"[All Fields]) OR "oral mucositis"[All Fields])

Comments on
The Evidence

Validity: This systematic review of 14 RCTs used two review authors that independently screened electronic search results. Patient groups were similar at the start, then varied in their treatment plans of receiving oral cryotherapy or not. The study authors of the RCTs were contacted for information “when feasible.” The risk of bias was assessed by the authors; all included studies were determined to be at high risk of bias.
Perspective: This is a systematic review with a large patient group of 1280 patients. The size of the study and consistency of the results offer evidence that oral cryotherapy can be a reasonable approach to reducing oral mucositis in chemotherapy patients. There appears to be no long-term harmful side effects from the treatment in any of the follow-ups with the patients.

Applicability

Oral cryotherapy is a relatively simple and low-cost procedure that can be conducted during a session of chemotherapy treatment. It is unlikely to be done in a dental office setting, but it can easily be administered in a chemotherapy clinic. No side effects of oral cryotherapy were listed that differed from normal effects of chemotherapy. The low risk of adverse effects and potential benefits of the procedure make it easy to recommend for patients.

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